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Custom Mould For A Made-To-Measure Breast Implant

Arkansas rates for HCPCS 19396

An impression of the chest is taken and shaped so that a breast implant can be manufactured to match the individual's own contour. It is the preparatory step used when a standard, off-the-shelf implant would not fit the chest wall well, and the finished implant is placed inside the body at a later operation.

Rates data updated July 2026.

How much does Custom Mould For A Made-To-Measure Breast Implant cost?

$295

Typical negotiated rate. In Arkansas, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $1,820 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$234$158 to $295
FacilityA hospital or hospital-owned outpatient department$1,820$955 to $3,467

How much rates vary

Facilitymedian $1,820 · 10th to 90th $209 to $3,981Professionalmedian $234 · 10th to 90th $129 to $372
$200$500$1K$2K$5Kfacility $1,820professional $234

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$1,230.27
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$229.09
Typical High
$338.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$3,467.37
Typical High
$4,786.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$186.21
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$3,467.37
Typical High
$3,467.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$3,162.28
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$239.88
Typical High
$446.68

Where Arkansas sits

The same service costs 21.4 times more in California than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arkansas· 21st of 51

$295

CA $4,571WV $214

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.